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Management of Cardiac Devices in Hospice and Palliative Care Patients

 

Management of advanced cardiac disease increasingly involves implantation of permanent devices aimed at improving morbidity and mortality. These devices, specifically implantable cardioverter-defibrillators (ICDs) and left-ventricular assist devices (LVADs), are usually intended to remain in place and function until death. However, with the heart failure community’s growing awareness of benefits of hospice and palliative care, greater attention is shifting to helping patients with end-stage cardiac disease enroll in hospice and die outside of the hospital setting. What is the role for implantable cardiac devices at end of life? When and how should these devices be deactivated? How do hospice clinicians engage in conversations with patients and families about cardiac device deactivation? In this course, participants will cultivate awareness of these issues to better serve hospice patients with advanced cardiac disease.

$40.00

Hours: 1.25
REL-PAC-AAHPM-MCD

Certificates

Certificates provided by accrediting body (10 Match)

California Board of Registered Nursing

1.25 HOURS


Provider approved by the California Board of Registered Nursing, CEP# 13791

Nurses will receive 1.25 contact hours for participating in this course.

District of Columbia Board of Nursing

1.2 HOURS


DC-RN -- District of Columbia Board of Nursing Approved Continuing Education program (CE Provider #50-290).

Nurses will receive 1.20 contact hours for participating in this course.

Florida Board of Nursing

1.0 HOURS


Florida Board of Nursing CE Provider #: 50-290

Nurses will receive 1.00 contact hours for participating in this course.

American Nurses Credentialing Center

1.25 HOURS


Relias, LLC is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Nurses will receive 1.25 contact hours for participating in this course.

Georgia Board of Nursing

1.25 HOURS


Georgia Board of Nursing CE Provider #: 50-290

Nurses will receive 1.25 contact hours for participating in this course.

Accreditation Council for Continuing Medical Education

1.25 HOURS


Relias LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Relias LLC designates this enduring material activity for a maximum of 1.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

South Carolina Board of Nursing

1.25 HOURS


This program was approved by the South Carolina Board of Nursing Approved Continuing Education Program (CE provider #50-290) CE Broker Course # 20-[Custom_Code]

Florida Board of Medicine

1.25 HOURS


Florida Board of Medicine CE Provider #: 50-290

Florida Physician Assistants

1.25 HOURS


West Virginia Board of Registered Nursing

1.25 HOURS


Course Details

Course Code: REL-PAC-AAHPM-MCD
Hours: 1.25
Type: Online Course
Content Expiration Date: 9/30/2021
Learning Objectives:
Identify basic components of ICD-pacemaker and LVAD devices.
Determine indications for ICD and LVAD device deactivation at end of life.
Formulate symptom management plans for device deactivation in hospice settings.

Outline:
Heart Failure in the United States

Overview of Heart Failure

Pathophysiology of Advanced Heart Failure

Heart Failure Classification

Medicare Hospice Benefit Criteria

Overview of ICD-pacemakers

Indications for ICD

Device Design

Indications for ICD Deactivation

Discussing ICD Deactivation

Ethical Issues

Practical Steps

Emergency Deactivation of ICD

Mechanical Circulatory Support Devices

Left Ventricular Assist Device

Complications from LVAD Implantation

Ethics of LVAD Deactivation

Pathophysiology of End of Life After LVAD Deactivation

Symptom Management Post LVAD-deactivation

Dyspnea in Advanced Heart Failure

Dyspnea in Advanced Heart Failure: Diuresis

Pain Management in Advanced Heart Failure

Resources

References

Instructor: Hunter Groninger, MD FACP FAAHPM

Dr. Groninger serves as Director of the Section of Palliative Care at MedStar Washington Hospital Center and as an Associate Professor of Medicine at Georgetown University. He also serves as Program Director for the MedStar Health/Washington Hospital Center hospice and palliative medicine fellowship program. Dr. Groninger is also a Master Facilitator with the Education for Palliative and End-of-Life Care (EPEC) Program at Northwestern University and Adjunct Faculty in the Center for Biomedical Ethics and Medical Humanities at the University of Virginia. His research interests include palliative care delivery in cardiovascular medicine, innovative symptom management strategies, word choice in complex communication, and the medical humanities.

Disclosure: Hunter Groninger, MD FACP FAAHPM has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Target Audience:
The target audience for this course is: Nurses; Physicians; Physician Assistants; in the following settings: Palliative Care.
Relias will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.
Course Delivery Method and Format
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
Relias has a grievance policy in place to facilitate reports of dissatisfaction. Relias will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias.
If you require special accommodations to complete this module, please contact Relias Support by completing the web form (https://www.relias.com/help) or by using the chat functionality.
All courses offered by Relias, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
Reference herein to any specific commercial product, process, or service by trade name, trademark, service mark, manufacturer or otherwise does not constitute or imply any endorsement, recommendation, or favoring of, or affiliation with, Relias, LLC.
All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
Accommodations
If you require special accommodations to complete this module, please contact Relias Customer Support here.

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